Active NPI
Barry Weiner, M.D.
- Nephrology Physician
- Jersey City, NJ
National Provider Identifier
1922180348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 25MA02569800
- Practice address
- 109 Pacific Ave
Jersey City, NJ 07304-3217 - Phone
- (201) 434-0008
- Fax
- (204) 451-2863
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 25MA02569800 | NJ | Primary |
Addresses
Primary practice location
109 Pacific Ave
Jersey City, NJ 07304-3217
Mailing address
20011 Keno Ave
Hollis, NY 11423-1435
Phone (718) 465-8792
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2922801 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA02569800 | NJ | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922180348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20011 KENO AVE",
"city": "HOLLIS",
"state": "NY",
"postal_code": "114231435",
"telephone_number": "718-465-8792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 PACIFIC AVE",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073043217",
"telephone_number": "201-434-0008",
"fax_number": "204-451-2863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEINER",
"first_name": "BARRY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "NJ",
"license": "25MA02569800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2922801",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.